30 articles - From Friday May 06 2022 to Friday May 13 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
meta-analyses and systematic reviews
| Clin J Am Soc Nephrol |
Diagnostic Performance of Fractional Excretion of Sodium for the Differential Diagnosis of Acute Kidney Injury: A Systematic Review and Meta-Analysis. Fractional excretion of sodium has a limited role for AKI differentiation in patients with a history of CKD or those on diuretic therapy. It is most valuable when oliguria is present. |
| Nephrol Dial Transplant |
Intravenous sodium thiosulphate for vascular calcification of hemodialysis patients - a systematic review and meta-analysis. No reduction in BMD by STS was observed. Intravenous STS may attenuate the progression of vascular calcification and arterial stiffness in hemodialysis patients. Large and well-designed randomized controlled trials are warranted. |
Seroconversion rate after primary vaccination with two doses of BNT162b2 versus mRNA-1273 in solid organ transplant recipients: a systematic review and meta-analysis. This systematic review and meta-analysis indicates that, in SOT recipients, higher seroconversion rates were observed after vaccination with mRNA-1273 compared to BNT162b2. |
RCT, clinical trials, retrospective studies, etc…
| J Am Soc Nephrol |
A Composite Endpoint of Graft Status and eGFR at 1 Year to Improve the Scientific Registry of Transplant Recipients' Five-Tier Rating System. This proof-of-concept study suggests that a composite endpoint incorporating allograft function may improve the posttransplant component of the five-tier system by better differentiating between transplant programs with respect to long-term graft outcomes. |
Factor H-Related Protein 1 Drives Disease Susceptibility and Prognosis in C3 Glomerulopathy. Our findings explain how FHR-1 mutants with duplicated dimerization domains result in predisposition to C3G. They also provide a pathogenic mechanism that may be shared by other diseases, such as IgA nephropathy or age-related macular degeneration, and identify FHR-1 as a potential novel therapeutic target in C3G. |
Myeloid CCR2 Promotes Atherosclerosis after Acute Kidney Injury. Our data introduce an experimental model of remote proatherogenic effects of renal IR and delineate myeloid CCR2 signaling as a mechanistic requirement. Monocytes should be considered as mobile mediators when addressing systemic vascular sequelae of kidney injury. |
Tumor Lysis Syndrome and AKI: Beyond Crystal Mechanisms. The mechanisms of histone-mediated damage implicates endothelial cell activation mediated by Toll-like receptor 4. Heparin inhibits extracellular histones and mitigates endothelial dysfunction during TLS. This study sheds new light on the pathophysiology of TLS-induced AKI and suggests that extracellular histones may constitute a novel target for therapeutic intervention in TLS when endothelial dysfunction occurs. |
| Kidney Int |
Biological pathways and comparison with biopsy signals and cellular origin of peripheral blood transcriptomic profiles during kidney allograft pathology. Similarly, in peripheral blood scRNASeq analysis, these genes were overexpressed in ABMR in immune cell subtypes. Furthermore, overexpression of these genes in ABMR was confirmed in independent cohorts in blood and biopsy. Thus, our results highlight the immune activation pathways in peripheral blood leukocytes at the time of kidney allograft pathology, despite the use of current strong immunosuppressants, and provide a framework for future therapeutic interventions. |
Clinicopathological characteristics of high-altitude polycythemia-related kidney disease in Tibetan inhabitants. Expansion of the arterial/arteriolar medial wall area characterized by smooth muscle cell proliferation was clearly observed, potentially indicating vascular remodeling. Hypoxia-inducible factor 2a was expressed in the kidney tissues of these patients. Thus, the pathological changes of HAPC-related kidney disease encompassed both glomerular and extraglomerular vascular lesions, suggesting a key role of both chronic hypoxia itself and secondary hemodynamic changes in the pathogenesis of this disease. |
Soluble a-klotho and heparin modulate the pathologic cardiac actions of fibroblast growth factor 23 in chronic kidney disease. We also developed a novel procedure for the synthesis and purification of recombinant soluble klotho, which showed anti-hypertrophic effects in FGF23-treated cardiac myocytes. Thus, soluble klotho and heparin act as independent FGF23 co-receptors with opposite effects on the pathologic actions of FGF23, with soluble klotho reducing and heparin increasing FGF23-induced cardiac hypertrophy. Hence, whether heparin injections during hemodialysis in patients with extremely high serum FGF23 levels contribute to their high rates of cardiovascular events and mortality remains to be studied. |
Susceptibility to kidney fibrosis in mice is associated with early growth response-2 protein and tissue inhibitor of metalloproteinase-1 expression. EGR2 over-expression in cultured HEK293 cells induced TIMP-1 while EGR2 silencing hindered TGF-ß induced TIMP-1 production in HK-2 cells and ureteral obstructed kidneys. Finally, EGR2 and TIMP1 was increased in human kidneys manifesting focal segmental glomerulosclerosis suggesting a correlation between animal studies and patient clinical settings. Thus, our observations demonstrate a strong relationship between genetic background and the progression of kidney fibrosis, which might involve early altered EGR2 and TIMP-1 response, but the relationship to patient genetics remains to be explored. |
The characteristics of seronegative and seropositive non-hepatitis-associated cryoglobulinemic glomerulonephritis. We conclude that most CryoGN cases (types I and II) are due to a hematologic condition and are associated with favorable outcome after clone-directed therapy. Seronegative CryoGN accounts for about a quarter of cases and is mostly a kidney-limited disease. Thus, further investigations are needed to unravel the pathophysiology of seronegative CryoGN. |
| Nephrol Dial Transplant |
Association of osteopontin with kidney function and kidney failure in chronic kidney disease patients: the GCKD study. After 6 years, 31% of the KF events could be attributed to higher OPN levels (95%CI: [3%,56%]). In this study, higher OPN levels were associated with kidney function markers worsening, and a higher risk for adverse outcomes. A larger proportion of KF could be attributed to higher OPN levels warranting further research on OPN with regards to its role in CKD progression and possible treatment options. |
Belatacept rescue conversion in kidney transplant recipients with vascular lesions (Banff cv score > 2): a retrospective cohort study. The replacement of CNI with belatacept in patients with decreased allograft function and vascular lesions is associated with an improvement in graft survival, and represents a valuable option in a context of organ shortage. Caution should be made about the increased risk of opportunistic infection. |
End-to-end interstitial fibrosis assessment of kidney biopsies with a machine learning-based model. The model showed significantly better test-retest reliability (ICC 0.98) than humans (ICC 0.76 to 0.94), and the amount of interstitial fibrosis inferred by the model strongly correlated with 405 patients' serum creatinine (r = 0.65 to 0.67) and eGFR (r = -0.74 to -0.76). This study demonstrated that a trained machine learning-based model can faithfully simulate the whole process of interstitial fibrosis assessment, which traditionally can only be carried out by renal pathologists. Our data suggested that such a model may provide more reliable results, thus enabling precision medicine. |
Kidney function at 3 months after acute kidney injury is an unreliable indicator of subsequent kidney dysfunction: the NARA-AKI Cohort Study. AKI was associated with worse kidney outcomes, regardless of eGFR at 3 months after surgery. Creatinine-based eGFR values at 3 months after AKI might be affected by acute illness-induced loss of muscle mass. Kidney function might be more accurately evaluated much later after surgery or using cystatin C values. |
Multidisciplinary management of chronic refractory pain in autosomal dominant polycystic kidney disease. At the end of follow-up only in 13 patients (12.9%) surgical intervention was necessary: 11 nephrectomies (of which 10 in patients already on kidney function replacement treatment), 1 liver transplantation, 1 partial hepatectomy. After a median follow-up of 4.5 [2.5-5.3] years, 69.0% of the patients still had less pain complaints. these data indicate that our multidisciplinary treatment protocol appears effective in reducing pain in the majority of patients with chronic refractory pain, while postponing or even avoiding in most patients surgical interventions as nephrectomy. |
Retrospective analysis of the impact of severe obesity on kidney transplant outcomes. On multivariable analysis, recipients with BMI = 35 kg/m2 had increased odds of SSIs compared with normal-weight recipients (odds ratio [OR], 3.34, 95% CI 1.55-7.22, p = 0.022). On multivariable and Kaplan-Meier analyses, no BMI groups demonstrated increased odds for death-censored graft failure. Severe obesity in kidney transplant recipients is associated with increased SSIs, but not kidney allograft failure. |
Urea levels and cardiovascular disease in patients with chronic kidney disease. After multiple adjustments for cardiovascular risk factors (including eGFR), patients in T3 had a higher risk of atheromatous and nonatheromatous cardiovascular events than patient in T1 (n events = 451, HR[95%CI]: 1.93[1.39-2.69]). The adjusted HRs for death before RRT (n events = 407) were 1.31[0.97; 1.76] and 1.73[1.22; 2.45] for patients T2 and those in T3, respectively. Interpretation Our data suggested that urea is a predictor of cardiovascular outcomes beyond CV risk factors including eGFR. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Am J Kidney Dis |
Metabolic Alkalosis Pathogenesis, Diagnosis, and Treatment: Core Curriculum 2022. These factors include volume contraction, low glomerular filtration rate, potassium deficiency, hypochloremia, aldosterone excess, and elevated arterial carbon dioxide. Major clinical states are associated with metabolic alkalosis, including vomiting, aldosterone or cortisol excess, licorice ingestion, chloruretic diuretics, excess calcium alkali ingestion, and genetic diseases such as Bartter syndrome, Gitelman syndrome, and cystic fibrosis. In this installment in the AJKD Core Curriculum in Nephrology, we will review the pathogenesis of metabolic alkalosis; appraise the precipitating events; and discuss clinical presentations, diagnoses, and treatments of metabolic alkalosis. |
| Nephrol Dial Transplant |
Letters to the editors and authors’ replies
all remaining publications eg case reports, images of the month, etc…
| Clin J Am Soc Nephrol |
| J Am Soc Nephrol |
| Nat Rev Nephrol |